Methylmercury, a neurotoxin present in all ocean fish, has been associated
with severe neurodevelopmental damage following high levels of in utero exposure.
In a prospective study conducted in the Republic of Seychelles, where the
typical diet is high in ocean fish, Dr Davidson and coworkersArticle did not detect
neurodevelopmental deficits in children at 66 months of age who had prenatal
and postnatal methylmercury exposure. In an editorial, Dr MahaffeyArticle notes that
subtle neurocognitive deficits may be difficult to detect and cautions women
of childbearing age to be aware of the mercury contamination of the fish they
consume.

Severe Social Phobia Eased by Paroxetine

Social phobia, an underdiagnosed and undertreated anxiety disorder,
may result in marked emotional, social, and occupational impairment. In a
12-week multicenter controlled trial, Dr Stein and colleagues found that treatment
with paroxetine significantly reduced the symptoms associated with generalized
social phobia compared with placebo and was well tolerated.

The association between UV-B radiation in sunlight and cataract development
has been reported in men with high occupational exposure to sunlight. In a
population-based sample of older individuals with ordinary levels of sunlight
exposure, Dr West and coworkers found that cumulative sunlight exposure was
correlated with the risk of cortical cataracts.

Ovarian cancer is particularly lethal because it is often detected after
widespread metastases have already occurred. Dr Xu and coworkersArticle found that
women with ovarian cancer, including stage I disease, and women with other
gynecologic malignancies had significantly higher levels of plasma lysophosphatidic
acid than healthy controls. In an editorial, Dr RobertsArticle discusses issues that
must be addressed before using lysophosphatidic acid levels in clinical practice.

Late-term Abortion

Dr Gans Epner and colleaguesArticle present a scholarly review of the scientific
and medical information key to an understanding of the current debate about
the legislative ban on late-term abortion. In an editorial, Dr LundbergArticle explains JAMA's
responsibility to provide discussion and debate on difficult and even divisive
issues in medicine.

A 45-Year-Old Man With Low Back Pain

Many people experience low back pain and face a perplexing array of
possible therapeutic interventions and conflicting recommendations. In this
Clinical Crossroads, Mr S, an avid jogger, has had episodic low back pain
for years but seeks evaluation because of residual numbness of his left foot
after an especially severe occurrence of back pain. Dr Weinstein reviews the
evidence for medical and surgical interventions.